Detection of Fractured Endodontic Instruments in Root Canals: Comparison between Different Digital Radiography Systems and Cone-beam Computed Tomography

Brito, Ana Caroline Ramos de; Verner, Francielle Silvestre; Junqueira, Rafael Binato; Yamasaki, Mayra Cristina; Queiroz, Polyane M.; Freitas, Deborah Queiroz; Oliveira‐Santos, Christiano

doi:10.1016/j.joen.2016.11.017

Cited by 30 publications

(17 citation statements)

References 34 publications

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“…Although smaller voxel sizes act to improve the spatial resolution thus providing more detail in the image (Cebe et al ), a higher dose of radiation is necessary to generate high‐quality images (Venskutonis et al ). A previous study reported that larger voxels did not interfere in the diagnostic accuracy of fractured instruments detection (Ramos Brito et al ); therefore, a 0.2 mm voxel was used in the present study.…”

Section: Discussionmentioning

confidence: 99%

“…According to the guidelines of AAE & AAOMR Joint Position Statement () and ESE (), CBCT examinations are indicated only in cases where two‐dimensional techniques do not provide sufficient information for a diagnosis and treatment plan, due to the high radiation dosage and cost when compared to intraoral radiographs (Koç et al ). In the present study, intraoral radiographs were not included, since their use in the detection of fractured instruments is well documented (Rosen et al , Ramos Brito et al ) and have also been compared with CBCT images (Rosen et al , Ramos Brito et al ). Also, the main objective of the present study was to evaluate the use of the MAR tool, which is only available for CBCT images.…”

Section: Discussionmentioning

confidence: 99%

“…Teeth with previous endodontic treatments, presence of root caries lesions, as well as root resorption, visible root fractures or fissures, supernumerary roots and pulp calcifications were excluded. The root canals were divided into four groups: (i) the control group, with nonfilled canals; (ii) the fracture group, with nonfilled canals and fractured files; (iii) the fill group, with filled canals; and (iv) the fill/fracture group, with filled canals and fractured files (Ramos Brito et al ). The distribution of such conditions was random amongst the canals, and each tooth could have different conditions in its mesiobuccal, mesiolingual and distal canals.…”

Section: Methodsmentioning

confidence: 99%

“…Tooth preparation followed the methodology proposed by Ramos Brito et al (), with all stages being performed by an endodontist. For this, root canal preparation was performed with a single file (R25 instrument, 25 mm; VDW, Munich, Germany), followed by irrigation with 2.5% sodium hypochlorite, final irrigation with EDTA and drying of the canals.…”

Section: Methodsmentioning

confidence: 99%

“…Brightness, contrast and zoom tools were used according to the visual needs of each evaluator. The roots were evaluated for the presence or absence of fracture instruments in the root canals, according to a five‐point scale (1‐definitely absent, 2‐probably absent, 3‐uncertain, 4‐probably present, 5‐definitely present; Ramos Brito et al ). After 30 days, 25% of the sample was re‐evaluated to assess intra‐ and inter‐evaluator reproducibility.…”

Section: Methodsmentioning

confidence: 99%

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Use of the metal artefact reduction tool in the identification of fractured endodontic instruments in cone‐beam computed tomography

et al. 2019

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Aim To evaluate the influence of the metal artefact reduction (MAR) tool in the diagnosis of fractured instruments in root canals of extracted mandibular molars, with or without root canal fillings. Methodology The root canals of 31 mandibular molars were divided into four groups: (i) the control group, without root fillings; (ii) the fracture group, without fillings and with fractured files; (iii) the fill group, with root filling; and (iv) the fill/fracture group, root filled and with fractured files. The following instruments were used as fractured endodontic instruments: stainless steel hand files, NiTi reciprocating files and NiTi rotary files. Each tooth was inserted in a dry mandible to obtain cone‐beam computed tomography (CBCT) images using a CBCT OP300 3D Maxio (Instrumentarium Dental, Tuusula, Finland) and Picasso Trio (Vatech, Hwaseong, Republic of Korea), with and without application of the MAR tool. All images were evaluated by three radiologists for the presence or absence of fractured files on a 5‐point scale. The diagnostic accuracy (area under ROC curve) was calculated. Image noise was measured in regions of trabecular and cortical bone and soft tissue. The comparison between the ROC curve values with the MAR tool enabled or disabled was performed using a t‐test. A t‐test was also employed for comparing image noise when the MAR tool was enabled and disabled. The significance level was set at 5%. Results The use of the MAR tool did not influence the diagnostic accuracy for identifying fractured endodontic instruments in root canals with and without fillings in both CBCT systems (P > 0.05), nor did it influence the image noise (P > 0.05). Conclusions The MAR tool on these two devices did not increase the detection of fractured endodontic instruments and did not reduce image noise using extracted mandibular molars. Therefore, the MAR tool is not recommended for evaluation of fractured endodontic instruments in teeth with and without root fillings in mandibular molars.

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Section: Discussionmentioning

confidence: 99%